Smoking cessation is associated with increased plasma adiponectin levels in men with stable angina, suggesting that the significance of smoking cessation may be partly explained by the increase in adiponectin level.
IMPORTANCE Posttrabeculectomy changes in bleb parameters measured using 3-dimensional (3-D) anterior-segment optical coherence tomography (OCT) remain uncharacterized and might be related to postsurgical intraocular-pressure (IOP) control. OBJECTIVE To evaluate time-dependent posttrabeculectomy changes in filtering bleb parameters using 3-D anterior-segment OCT. DESIGN, SETTING, AND PARTICIPANTS This prospective observational study was conducted at Kumamoto University Hospital, Kumamoto, Japan. Patients with open-angle glaucoma who underwent uncombined fornix-based trabeculectomy at Kumamoto University Hospital between January 1, 2012, and October 31, 2012, were included. Twenty-nine eyes were enrolled, 23 of which were followed up for 1 year without additional glaucoma surgical procedures; 3 required additional glaucoma surgery. INTERVENTIONS Imaging filtering blebs using 3-D anterior-segment OCT.MAIN OUTCOMES AND MEASURES The primary end points were changes in bleb parameters including the position and width of the filtration openings on the scleral flap, the total bleb height, fluid-filled cavity height, bleb wall thickness, and bleb wall intensity, which were measured using 3-D anterior-segment OCT. The secondary end points were postsurgical IOP measured 0.5, 3, 6, and 12 months after trabeculectomy, and the effects of aqueous cytokine levels on the bleb parameters. RESULTS We observed increased total bleb height (0.82 to 1.25 mm; difference: 95% CI, 0.10 to 0.75; P = .01), bleb wall thickness (0.46 to 0.61 mm; difference: 95% CI, 0.02 to 0.28; P = .03), and distance from the top of the scleral flap to the filtration opening (1.69 to 2.16 mm; difference: 95% CI, 0.28 to 0.70; P < .001), as well as decreased width of the filtration opening (2.08 to 1.12 mm; difference: 95% CI, −1.75 to −0.49; P = .002) between 0.5 and 12 months posttrabeculectomy. The filtration openings tended to close from the fornix side of the scleral flap during the wound healing process. Moreover, the width of the filtration opening at 0.5 months posttrabeculectomy correlated with the IOP at 12 months (P = .02). The aqueous humor level of monocyte chemoattractant protein-1 was correlated with the width of the filtration opening at 3 and 6 months posttrabeculectomy. CONCLUSIONS AND RELEVANCEThe width of the filtration opening at 0.5 months posttrabeculectomy correlated with the IOP at 12 months. The width of the filtration opening at the early stage may be a prognostic factor for long-term IOP control. Large-scale studies with longer follow-up periods are required.
Circulation Journal Official Journal of the Japanese Circulation Society http://www. j-circ.or.jp oronary artery disease (CAD) is a life-threatening condition that encompasses systemic atherosclerosis. Many basic-research, epidemiological, and clinical studies have been conducted with the aim of combating atherosclerotic disease. Together with aging, the progression of atherosclerosis leads to an increase in stiffening of the aorta, and in turn an increase in pulse pressure (PP) through a reduction in arterial compliance and increased pulse wave velocity. 1 Therefore, increased PP is considered as a sign of increased arterial stiffness. Elevated PP and decreased arterial compliance are also recognized as risk factors for CAD. 1,2Indices of intrarenal vascular resistance calculated from pulsed-wave Doppler velocities, such as pulsatility index (PI) and resistive index (RI), correlate positively with PP and negatively with the carotid hemodynamic pattern in patients with essential hypertension. 3 This pattern was determined by calculating the ratio of diastolic to systolic mean velocity in pulsed Doppler flow recordings of the common carotid artery. The same ratio also showed a significant negative correlation with PP and carotid arterial stiffness. 4 These findings suggest that hemodynamic Doppler flow patterns may reflect not only peripheral vascular resistance but also systemic arterial stiffness.The ophthalmic artery (OA) is the first major branch of the internal carotid artery and divides into many branches in the orbital area. Doppler imaging of the OA was recently made possible by improvements in Doppler equipment. 5 Changes in OA blood flow assessed on pulsed Doppler (OA Doppler) have provided new insights into various vascular disorders including ophthalmic diseases, carotid artery stenosis, and diabetes mellitus. 5 OA Doppler has particular anatomical advantages due to the absence of ultrasonic obstacles and the vertical angle, which differs from the parallel-signaling of carotid artery Doppler to the transducer. Such findings in the ocular fundus are associated closely with systemic atherosclerosis, with previous reports showing that atherosclerotic changes in retinal arteries are potential markers of systemic cardiovascular disease. 6,7 OA Doppler flow patterns may also reflect the severity of diabetes retinopathy. 8,9 Fukuda et al showed that the ratio of systolic to diastolic mean velocity in OA Doppler is closely involved in age and the severity of diabetic retinopathy. 10 There is little information on the relationship between OA Doppler flow and systemic atherosclerosis. We hypothesized Background: Doppler imaging of ophthalmic artery (OA), the first major branch of the internal carotid artery, provides anatomical advantages due to the vertical angle to the body surface and absence of ultrasonic obstacles. It was hypothesized that the Doppler waveform indices of OA correlate with severity of systemic atherosclerosis.
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